Provider Demographics
NPI:1457753279
Name:MASTEN, MARNIE LYNN (LPCC)
Entity Type:Individual
Prefix:
First Name:MARNIE
Middle Name:LYNN
Last Name:MASTEN
Suffix:
Gender:F
Credentials:LPCC
Other - Prefix:
Other - First Name:
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Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:601 S EDWIN C MOSES
Mailing Address - Street 2:4TH FLOOR NW BLDG, SAMARITAN BEHAVIORAL HEALTH, INC.
Mailing Address - City:DAYTON
Mailing Address - State:OH
Mailing Address - Zip Code:45417-3424
Mailing Address - Country:US
Mailing Address - Phone:937-734-4393
Mailing Address - Fax:937-567-3492
Practice Address - Street 1:601 S EDWIN C MOSES BLVD
Practice Address - Street 2:1ST FLOOR, NW BLDG, SAMARITAN BEHAVIORAL HEALTH, INC.
Practice Address - City:DAYTON
Practice Address - State:OH
Practice Address - Zip Code:45417-3424
Practice Address - Country:US
Practice Address - Phone:937-734-4393
Practice Address - Fax:937-567-3492
Is Sole Proprietor?:No
Enumeration Date:2014-09-24
Last Update Date:2014-10-16
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OHE-0003230101YM0800X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YM0800XBehavioral Health & Social Service ProvidersCounselorMental Health